Brook T Fantaw

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Practice address

3621 Williston Rd
Minnetonka, MN 55345-2129

Phone

(952) 457-7546

NPI assigned

Mar 11, 2024

Last updated

Mar 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1427816784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 WILLISTON RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452129",
            "telephone_number": "952-457-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 WILLISTON RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452129",
            "telephone_number": "952-457-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTAW",
        "first_name": "BROOK",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristine Nicole Falness
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• Family Lifestyles, Counseling & Therapy
• Fardosa Abdullah Farah
• Samiya Farah
• Lindsey Rose Mornson Farmer, MA, LPCC
• Elizabeth Farnum
• Kendal Farrar, MD

• Home Health Agency in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.